Treatments

IVF Treatment with ICSI (Fresh Cycle)

Procedure:

Step 1. Inquiry (First detailed interview with Doctor)
Contact us through our website or email. Get a free video call with Dr. Nezih Durmazlar who will
discuss with you all the available options, success rates, preliminary treatment plans, and full
pricing. The conversation will last according to the patient’s history and needs, may last at least one
hour.

Step 2. Pre-Treatment
According to the couples, past history, relevant blood tests, and diagnostic procedures will be
requested and discussed with Dr. Nezih Durmazlar. Get the necessary documentation and a detailed
schedule of the follow-up and treatment.

Step 3. Follow up
Get instructions for the following steps and the list of medical tests and examinations
recommended. Depending on the patient’s location we can make an arrangement for collaborative
follow-up with the head doctor through video calls.

Step 4. Controlled ovarian hyperstimulation (first part)
According to the relevant schedule specifically designed for the couple treatment will be started with
the first 3 days of menstruation. During menstruation in the first visit, the patient will have an
ultrasound and blood work. If those results are fine, she will start taking the subcutaneous
medication for 5-8 days (with transvaginal ultrasound and blood work every 2-3 days).

Step 5. Controlled ovarian hyperstimulation (second part)
The couple arrives in Ankara, Turkey, and stays for 8-10 days. In that period, visits the clinic 1-2 times
and meets Dr. Durmazlar in person. The husband will give the sperm.
If needed eventual sperm vitrification is done. Discussion of the treatment plan. Signing consent
forms and agreements. Payment. The male partner can fly back home one day after oocyte
collection.

Step 6. Egg retrieval & embryo development (5 days)
IVF/ICSI. Embryo development until blastocyst stage.

Step 7. Embryo transfer
Embryo transfer is performed five days after the egg retrieval. It takes just 30-60 minutes. The
female patient flies back home after the embryo transfer.

Step 8. Pregnancy result
On day 9 after the embryo transfer, the patient has an HCG test.

* The treatment plan is a statistically average model designed for your convenience when planning
your trip to Ankara, Turkey. It may undergo changes both in terms of time-limits and its content
depending on the factual health condition of every individual patient.

IVF - ICSI with PGT-A (In Fresh Cycle)

Procedure:

Step 1. Inquiry
Contact us through our website or email. Get a free video call with Dr. Nezih Durmazlar who will
discuss with you all the available options, success rates, preliminary treatment plans, and full
pricing. The conversation will last according to the patient's history and needs, which may last at
least one hour.

Step 2. Pre-Treatment
According to the couples, past history, relevant blood tests, and diagnostic procedures will be
requested and discussed with Dr. Nezih Durmazlar. Get the necessary documentation and a detailed
schedule of the follow-up and treatment.

Step 3 . Follow up
Get instructions for the following steps and the list of medical tests and examinations
recommended. Depending on the patient's location we can make an arrangement for collaborative
follow-up with the head doctor through video calls.

Step 4. Controlled ovarian hyperstimulation (first part)
According to the relevant schedule specifically designed for the couple treatment will be started with
the first 3 days of menstruation. During menstruation in the first visit, the patient will have an
ultrasound and blood work. If those results are fine, she will start taking the subcutaneous
medication for 5-8 days (with transvaginal ultrasound and blood work every 2-3 days).

Step 5. Controlled ovarian hyperstimulation (second part)
The couple arrives in Ankara, Turkey, and stays for 8-10 days. In that period, visits the clinic 1-2 times
and meets Dr. Durmazlar in person. The husband will give the sperm.
If needed eventual sperm vitrification is done. Discussion of the treatment plan. Signing consent
forms and agreements. Payment. The male partner can fly back home one day after oocyte
collection.

Step 6. Egg retrieval & embryo development (5 days)
IVF/ICSI. Embryo development until blastocyst stage.

Step 7. Embryo biopsy
According to patients' clinical needs, blastocyst biopsy is generally performed on the 5th day of
embryo development.

There are two options available:
1. Embryo biopsy for PGT-A and vitrification.
2. Embryo biopsy for PGT-A (fast lab results approx. 8 hours the same day), and fresh transfer.
Option 1. Frozen embryo transfer protocol. The results are discussed with patients over a video call.
It is usually launched 4 weeks after the egg retrieval. Hormone replacement therapy starts on day 2
of the cycle, after having an ultrasound and blood work. Oral estrogens are taken for 7-10 days.
Then, the second ultrasound and bloodwork confirm that the endometrium is ready. Five days before
the embryo transfer, the patient starts with progesterone (vaginal or intramuscular). The female
partner arrives at the clinic for the frozen embryo transfer. The female partner flies back home.
Option 2. Fresh Embryo transfer. The results are discussed with patients in person. Embryo transfer
is performed fresh. It takes just 30-60 minutes. The female patient flies back home after the embryo
transfer.

Step 8. Pregnancy result
On day 9 after the embryo transfer, the patient has an HCG test.

IVF - ICSI with PGT-A (In Frozen Cycle)

Procedure:

Step 1. Inquiry
Contact us through our website or email. Get a free video call with Dr. Nezih Durmazlar who will
discuss with you all the available options, success rates, preliminary treatment plans, and full
pricing. The conversation will last according to the patient's history and needs, which may last at
least one hour.

Step 2. Pre-Treatment
According to the couples, past history, relevant blood tests, and diagnostic procedures will be
requested and discussed with Dr. Nezih Durmazlar. Get the necessary documentation and a detailed
schedule of the follow-up and treatment.

Step 3. Follow up
Get instructions for the following steps and the list of medical tests and examinations
recommended. Depending on the patient's location we can make an arrangement for collaborative
follow-up with the head doctor through video calls.

Step 4. Controlled ovarian hyperstimulation (first part)
According to the relevant schedule specifically designed for the couple treatment will be started with
the first 3 days of menstruation. During menstruation in the first visit, the patient will have an
ultrasound and blood work. If those results are fine, she will start taking the subcutaneous
medication for 5-8 days (with transvaginal ultrasound and blood work every 2-3 days).

Step 5 . Controlled ovarian hyperstimulation (second part)
The couple arrives in Ankara, Turkey, and stays for 8-10 days. In that period, visits the clinic 1-2 times
and meets Dr. Durmazlar in person. The husband will give the sperm.
If needed eventual sperm vitrification is done. Discussion of the treatment plan. Signing consent
forms and agreements. Payment. The male partner can fly back home one day after oocyte
collection.

Step 6. Egg retrieval & embryo development (5 days)
IVF/ICSI. Embryo development until blastocyst stage.

Step 7. Embryo biopsy
According to patients' clinical needs, blastocyst biopsy is generally performed on the 5th day of
embryo development.

There are two options available:
1. Embryo biopsy for PGT-A and vitrification.
2. Embryo biopsy for PGT-A (fast lab results approx. 8 hours the same day), and fresh transfer.
Option 1. Frozen embryo transfer protocol. The results are discussed with patients over a video call.
It is usually launched 4 weeks after the egg retrieval. Hormone replacement therapy starts on day 2
of the cycle, after having an ultrasound and blood work. Oral estrogens are taken for 7-10 days.
Then, the second ultrasound and bloodwork confirm that the endometrium is ready. Five days before
the embryo transfer, the patient starts with progesterone (vaginal or intramuscular). The female
partner arrives at the clinic for the frozen embryo transfer. The female partner flies back home.
Option 2 . Fresh Embryo transfer. The results are discussed with patients in person. Embryo transfer
is performed fresh. It takes just 30-60 minutes. The female patient flies back home after the embryo
transfer.

Step 8. Pregnancy result
On day 9 after the embryo transfer, the patient has an HCG test.

Frozen Embryo Transfer Cycle (Thawed ET)

Procedure:

Step 1. Inquiry (First detailed interview with Doctor)
Contact us through our website or email. Get a free video call with Dr. Nezih Durmazlar who will
discuss with you all the available options, success rates, preliminary treatment plans, and full
pricing. The conversation will last according to patients' history and needs, which may last at least
one hour.

Step 2. Pre-Treatment
According to the couples, past history, relevant blood tests, and diagnostic procedures will be
requested and discussed with Dr. Nezih Durmazlar. Get the necessary documentation and a detailed
schedule of the follow-up and treatment.

Step 3. Follow up
Get instructions for the following steps and the list of medical tests and examinations
recommended. Depending on the patient's location we can make an arrangement for collaborative
follow-up with the head doctor through video calls.

Step 4. Controlled ovarian hyperstimulation (first part)
According to the relevant schedule specifically designed for the couple treatment will be started with
the first 3 days of menstruation. During menstruation in the first visit, the patient will have an
ultrasound and blood work. If those results are fine, she will start taking the subcutaneous
medication for 5-8 days (with transvaginal ultrasound and blood work every 2-3 days).

Step 5. Controlled ovarian hyperstimulation (second part)
The couple arrives in Ankara, Turkey, and stays for 8-10 days. In that period, visits the clinic 1-2 times
and meets Dr. Durmazlar in person. The husband will give the sperm.
If needed eventual sperm vitrification is done. Discussion of the treatment plan. Signing consent
forms and agreements. Payment. The male partner can fly back home one day after oocyte
collection.

Step 6 . Egg retrieval & embryo development (5 days)
IVF/ICSI. Embryo development until the blastocyst stage, and frozen with vitrification.

Step 7. Embryo transfer
Frozen embryos can be stored for years, and according to the patient's desires, the embryos can be
transferred at any time, in the first days of menstruation frozen embryo transfer protocol can be
started.
Frozen embryo transfer protocol. Hormone replacement therapy starts on day 2 of the next cycle,
after having an ultrasound and blood work. Oral estrogens are taken for 7-10 days. Then, the second
ultrasound and bloodwork confirm that the endometrium is ready. Five days before the embryo
transfer, the patient starts with progesterone (vaginal or intramuscular). The female partner arrives
at the clinic for the frozen embryo transfer. The female partner flies back home.

Step 8. Pregnancy result
On day 9 after the embryo transfer, the patient has an HCG test.

Microdissection TESE (Testicular Sperm Extraction)

Procedure:

Microsurgical Testicular Sperm Extraction TESE (Testicular Sperm Extraction)

Contact us through our website or email. Get a free video call with Dr. Nezih Durmazlar who will
discuss with you all the available options, success rates, preliminary treatment plans, and full
pricing. The conversation will last according to patients' history and needs, which may last at least
one hour.

The Day Before Your Procedure
Instructions for eating and drinking before your surgery

• 12 ounces of water
• Do not eat anything after midnight the night before your surgery. This includes hard candy
• and gum.
• Between midnight and up until 2 hours before your scheduled arrival time, you may drink a
• total of 12 ounces of water.
• Starting 2 hours before your scheduled arrival time, do not eat or drink anything. This
• includes water.
• Your doctor may give you more instructions for eating and drinking before your procedure.

The Day of Your Procedure

• Take your medications the morning of your procedure as instructed by your doctor. Take them with a few sips of water.
• Don’t put on any lotions, creams, powders, deodorant, makeup, or cologne.
• Remove any jewelry, including body piercings.
• Leave all valuables, such as credit cards and jewelry, at home.
• If you wear contact lenses, if possible, wear your glasses instead. If you don’t have glasses please bring a case for your contacts.

What to bring with you

• A list of the medications you take at home, including patches and creams.
• Medications for breathing problems (such as inhalers), medications for chest pain, or both.
• A case for your glasses or contacts.

What to expect
Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and
spell your name and date of birth many times. This is for your safety. People with the same or similar
names may be having procedures on the same day.
You will get general anesthesia (medication to make you sleepy) to put you to sleep during the
procedure. Your doctor will make a very small incision (surgical cut) in your scrotum (the pouch of
skin holding your testes). They will examine your testes using a tiny microscope and remove small
pieces of tissue from your testes. Then, your doctor will close the incision with sutures (stitches).
You will have a bandage (mummy wrap) around your scrotum and scrotal support to hold the
dressing in place.
After Your Procedure
You will recover in the Post Anesthesia Care Unit (PACU). When you wake up, you will be discharged
home or brought back to your hospital room, if you’re in the hospital for other reasons.
At home
You may have mild pain and tenderness in your scrotum for a few days. You will get a prescription
for pain medication. Take it as directed by your doctor.
You may also have mild bruising (a “black and blue” appearance) on your scrotum. Your penis and
scrotum may be swollen. This is normal and should go away over the next week.
Activity

• You can shower 3 days after your procedure. Don’t soak in a pool, bathtub, or hot tub for 2 weeks after your procedure.
• You can resume your normal activity 3 days after your procedure. If you develop new pain, or your pain gets worse, as you do more activities, limit your activity until your pain gets better.
• Don’t drive while you’re taking pain medication. The pain medication can make you drowsy.
• Don’t lift any objects heavier than 10 pounds (4.5 kilograms) for at least 2 weeks after your procedure.
• You can resume sexual activity 1 week after your procedure.

Call us if You Have:

• A temperature of 101°F (38.3°C) or higher
• Pain that doesn’t go away with pain medication chills
• Swelling in your scrotum or penis that’s getting worse
• Drainage or pus coming from your incision

* On the same day, the extract will be explored for any viable sperm and will be frozen.
IVF with ICSI fresh cycle
Step 1. Inquiry (First detailed interview with Doctor)
Contact us through our website or email. Get a free video call with Dr. Nezih Durmazlar who will
discuss with you all the available options, success rates, preliminary treatment plans, and full
pricing. The conversation will last according to the patient’s history and needs, may last at least one
hour.
Step 2. Pre-Treatment
According to the couples, past history, relevant blood tests, and diagnostic procedures will be
requested and discussed with Dr. Nezih Durmazlar. Get the necessary documentation and a detailed
schedule of the follow-up and treatment.
Step 3 . Follow up
Get instructions for the following steps and the list of medical tests and examinations
recommended. Depending on the patient’s location we can make an arrangement for collaborative
follow-up with the head doctor through video calls.
Step 4. Controlled ovarian hyperstimulation (first part)
According to the relevant schedule specifically designed for the couple treatment will be started with
the first 3 days of menstruation. During menstruation in the first visit, the patient will have an
ultrasound and blood work. If those results are fine, she will start taking the subcutaneous
medication for 5-8 days (with transvaginal ultrasound and blood work every 2-3 days).
Step 5. Controlled ovarian hyperstimulation (second part)
The couple arrives in Ankara, Turkey, and stays for 8-10 days. In that period, visits the clinic 1-2 times
and meets Dr. Durmazlar in person. The husband will give the sperm.
If needed eventual sperm vitrification is done. Discussion of the treatment plan. Signing consent
forms and agreements. Payment. The male partner can fly back home one day after oocyte
collection.
Step 6. Egg retrieval & embryo development (5 days)
IVF/ICSI. Embryo development until blastocyst stage.
Step 7. Embryo transfer
Embryo transfer is performed five days after the egg retrieval. It takes just 30-60 minutes. The
female patient flies back home after the embryo transfer.
Step 8. Pregnancy result
On day 9 after the embryo transfer, the patient has an HCG test.

PESA (Percutaneous Epididymal Sperm Aspiration)

Procedure:

Local anesthesia
Contact us through our website or email. Get a free video call with Dr. Nezih Durmazlar who will
discuss with you all the available options, success rates, preliminary treatment plans, and full
pricing. The conversation will last according to patients' history and needs, which may last at least
one hour.
PESA is a procedure performed for men who are having sperm retrieved for IVF/ICSI. It is done with
local anesthesia in the operating room or office and is coordinated with their female partner’s egg
retrieval. A needle is inserted in the testicle and tissue/sperm is aspirated. TESA is performed for
men with obstructive azoospermia (s/p vasectomy). Occasionally, TESA doesn’t provide enough
tissue/sperm and an open testis biopsy is needed.

IVF with ICSI fresh cycle
Step 1 . Inquiry (First detailed interview with Doctor)
Contact us through our website or email. Get a free video call with Dr. Nezih Durmazlar who will
discuss with you all the available options, success rates, preliminary treatment plans, and full
pricing. The conversation will last according to the patient’s history and needs, may last at least one
hour.
Step 2. Pre-Treatment
According to the couples, past history, relevant blood tests, and diagnostic procedures will be
requested and discussed with Dr. Nezih Durmazlar. Get the necessary documentation and a detailed
schedule of the follow-up and treatment.
Step 3. Follow up
Get instructions for the following steps and the list of medical tests and examinations
recommended. Depending on the patient’s location we can make an arrangement for collaborative
follow-up with the head doctor through video calls.
Step 4 . Controlled ovarian hyperstimulation (first part)
According to the relevant schedule specifically designed for the couple treatment will be started with
the first 3 days of menstruation. During menstruation in the first visit, the patient will have an
ultrasound and blood work. If those results are fine, she will start taking the subcutaneous
medication for 5-8 days (with transvaginal ultrasound and blood work every 2-3 days).
Step 5. Controlled ovarian hyperstimulation (second part)
The couple arrives in Ankara, Turkey, and stays for 8-10 days. In that period, visits the clinic 1-2 times
and meets Dr. Durmazlar in person. The husband will give the sperm.
If needed eventual sperm vitrification is done. Discussion of the treatment plan. Signing consent
forms and agreements. Payment. The male partner can fly back home one day after oocyte
collection.
Step 6. Egg retrieval & embryo development (5 days)
IVF/ICSI. Embryo development until blastocyst stage.
Step 7. Embryo transfer
Embryo transfer is performed five days after the egg retrieval. It takes just 30-60 minutes. The
female patient flies back home after the embryo transfer.
Step 8. Pregnancy result
On day 9 after the embryo transfer, the patient has an HCG test

Intrauterine Insemination (IUI)

Procedure:

Intrauterine insemination involves careful coordination before the actual procedure:

• Preparing the semen sample. Your partner provides a semen sample at the doctor's office, or a vial of frozen sperm can be thawed and prepared.
• Because nonsperm elements in semen can cause reactions in the woman's body that interfere with fertilization, the sample will be washed in a way that separates the highly active, normal sperm from lower quality sperm and other elements. The likelihood of achieving pregnancy increases by using a small, highly concentrated sample of healthy sperm.
• Monitoring for ovulation. Because the timing of IUI is crucial, monitoring for signs of impending ovulation is critical. To do this, you might use an at-home urine ovulation predictor kit that detects when your body produces a surge or release of luteinizing hormone (LH). Or, an imaging method that lets your doctor visualize your ovaries and egg growth (transvaginal ultrasound) can be done. You also may be given an injection of human chorionic gonadotropin (HCG) or medications to make you ovulate one or more eggs at the right time.
• Determining optimal timing. Most IUIs are done a day or two after detecting ovulation. Your doctor or other care provider will have a plan spelled out for the timing of your procedure and what to expect.

What you can expect

The visit for intrauterine insemination takes about 15 to 20 minutes and is usually done
in a doctor's office or clinic. The IUI procedure itself takes just a minute or two and
requires no medications or pain relievers. Your doctor or a specially trained nurse
performs the procedure.

During the procedure

While lying on an exam table, you'll put your legs into stirrups and a speculum will be
inserted into your vagina — similar to what you experience during a Pap test. During the
procedure, the doctor or nurse:

• Attaches a vial containing a sample of healthy sperm to the end of a long, thin, flexible tube (catheter)
• Inserts the catheter into your vagina, through your cervical opening and into your uterus
• Pushes the sperm sample through the tube into your uterus
• Removes the catheter, followed by the speculum

After the procedure

After insemination, you'll be asked to lie on your back for a brief period. Once the
procedure is over, you can get dressed and go about your normal daily activities. You
may experience some light spotting for a day or two after the procedure.
Results
Wait two weeks before taking an at-home pregnancy test. Testing too soon could
produce a result that is:

• False-negative. If pregnancy hormones aren't yet at measurable levels, the test result may be negative when, in fact, you really are pregnant.
• False-positive. If you're using ovulation-inducing medication such as HCG, the medication that's still circulating in your body could indicate a pregnancy when you really aren't pregnant.
   

Your doctor may instruct you to return about two weeks after your home kit results for a
blood test, which is more sensitive in detecting pregnancy hormones after fertilization.
If you don't become pregnant, you might try IUI again before moving on to other fertility
treatments. Often, the same therapy is used for three to six months to maximize
chances of pregnancy.

Egg Freeze

Procedure:

Egg freezing allows women to preserve their own eggs, frozen when they are young and healthy, to help them achieve pregnancy later.

WHY FREEZE?

• AGE 25
  - High ovarian reserve AND a high percent of genetically normal eggs
  - Strong chance of conceiving each month
• AGE 40
  - Fewer eggs AND each egg is less likely to be genetically normal
  - More difficult to become pregnant
• COUNT
  - Women are born with ~1 million eggs, but that is all the eggs they will ever have. This reserve declines as women age.
• EGG QUALITY
  - Eggs are either genetically normal or abnormal. Over time, the percentage of abnormal eggs increases.
• FERTILITY & AGE
  - Diminishing egg count and quality decrease your fertility as you age—accelerating around age 35.